Patient Evaluation for Bariatric Surgery
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Upper GI SurgeryDiagnostic
Bariatric Surgery Selection Criteria (ASMBS/IFSO 2024)
Bariatric Surgery Selection Criteria (ASMBS/IFSO 2024): Patient Evaluation for Bariatric Surgery → BMI Assessment (2024) → Obesity-Related Comorbidities...
Pathway Overview
11 steps
Algorithm Steps
11 total
01Start 02Decision BMI Assessment (2024)
- BMI ≥35: Eligible regardless of comorbidities
- BMI 30-34.9: Eligible if metabolic disease
- BMI <30: Generally not indicated
03Decision Obesity-Related Comorbidities
- T2DM, HTN, dyslipidemia
- OSA, NASH, GERD
- Obesity hypoventilation
04Decision Contraindications
- Active substance abuse
- Uncontrolled psych illness
- Unable to comply with follow-up
05End Not Currently Candidate
Address contraindications, medical management
06Action Multidisciplinary Evaluation
Nutrition, psych, medical optimization
- Nutritional education
- Psychological evaluation
- EGD if indicated
07Decision Procedure Selection
- Sleeve: most common, simpler
- RYGB: GERD, diabetes, higher BMI
- DS/SADI-S: super-obese, revision
08Action Sleeve Gastrectomy
50-60% EWL expected
09End Surgical Planning
Insurance auth, preop optimization, OR scheduling
10Action Roux-en-Y Gastric Bypass
60-70% EWL, best for GERD
- Path rejoins step 09Shared downstream outcome
11Action Duodenal Switch/SADI-S
Highest weight loss, more malabsorption
- Path rejoins step 09Shared downstream outcome
- Path rejoins step 05Shared downstream outcome
- Path rejoins step 04Shared downstream outcome
Guideline Source
ASMBS/IFSO Guidelines on Indications for Metabolic and Bariatric Surgery 2024
Clinical Safety Information
Clinical Decision Support — Not a Substitute for Clinical Judgment
Individual patient factors may require deviation from these recommendations.
Known Limitations
- 2024 guidelines lowered BMI threshold to 30 with comorbidities
- Insurance coverage may not align with current guidelines
- Procedure choice depends on surgeon experience and patient factors
Contraindicated Populations
Active substance abuseUncontrolled psychiatric illness
Applicable Regions
USAUUKEU
AU: OSSANZ bariatric criteria
UK: NICE obesity surgical guidelines
US: ASMBS 2024 guidelines
Version 1Next review: 2028-01-01
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Related Resources
Frequently Asked Questions
What is the Bariatric Surgery Selection Criteria (ASMBS/IFSO 2024)?
The Bariatric Surgery Selection Criteria (ASMBS/IFSO 2024) is a diagnostic clinical algorithm for Upper GI Surgery. It provides a structured decision tree to guide clinical decision-making, based on ASMBS/IFSO Guidelines on Indications for Metabolic and Bariatric Surgery 2024.
What guideline is the Bariatric Surgery Selection Criteria (ASMBS/IFSO 2024) based on?
This algorithm is based on ASMBS/IFSO Guidelines on Indications for Metabolic and Bariatric Surgery 2024 (DOI: 10.1016/j.soard.2024.01.001).
What are the limitations of the Bariatric Surgery Selection Criteria (ASMBS/IFSO 2024)?
Known limitations include: 2024 guidelines lowered BMI threshold to 30 with comorbidities; Insurance coverage may not align with current guidelines; Procedure choice depends on surgeon experience and patient factors. Individual patient factors may require deviation from these recommendations.
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